Celiac Disease
Celiac Disease is an autoimmune condition that specifically affects the mucosa (lining) of the small intestine. It is characterized by a reaction and subsequent damage to the small intestine that occurs after a person eats gluten, a protein found in wheat, barley, and rye.
When someone with Celiac Disease consumes gluten, their immune system attacks the small intestine's lining. This damage causes the small finger-like projections called villi to flatten (villous atrophy), impairing the body's ability to absorb nutrients.
What Are the Symptoms?
Because Celiac Disease affects nutrient absorption, symptoms can be digestive or systemic (affecting the whole body):
- Diarrhea
- Bloating
- Anemia (due to poor iron absorption)
- Stunted growth (particularly in children)
- In adults, it can cause problems like amenorrhea (absence of menstruation), infertility, and impotence.
How It's Diagnosed?
Diagnosis typically involves blood tests followed by confirmation through an endoscopy:
Serological Testing (Blood Tests): Doctors look for specific antibodies that the body produces in response to gluten, such as:
- IgA anti-tissue transglutaminase
- IgA antiendomysial antibodies
- Antigliadin antibodies
UGI Endoscopy and Biopsy: The diagnosis is confirmed by performing an upper gastrointestinal (UGI) endoscopy to visualize the small intestine and take a small tissue sample (biopsy). This sample is examined to confirm the characteristic villous atrophy.
Treatment:
Currently, the primary and most effective treatment is dietary management:
- Gluten Withdrawal: The core of treatment is completely removing all food items containing wheat, oats, barley, and rye from the diet. This allows the small intestine to heal.
- Dietary Supplements: Patients may need to take supplements to correct any existing nutritional deficiencies (like iron or vitamins) caused by the prior malabsorption.
- Steroids: In very severe cases, such as a celiac crisis where the patient is extremely ill, steroid medications may be temporarily prescribed to quickly suppress the inflammation.